QuantiFERON®-TB Gold Test CLE EXAM
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1. Tuberculosis is caused by
  a. a virus
  b. tuberculin inoculation
  c. a bacterium, Mycobacterium tuberculosis
  d. a mitogen

2. A person with a latent tuberculosis infection
a. will always have disease symptoms
b. may have no symptoms but are always contagious
c. will never develop the actual tuberculosis disease
d. may require treatment to prevent tuberculosis disease

3. Which of these statements about the QuantiFERON®-TB Gold Test is NOT true?
a. It may detect tuberculosis infection earlier than the tuberculin skin test
b. Results can be available to the physician faster than skin test
c. It is more subjective to reader error bias than tuberculin skin test
d. It is not affected by previous vaccination with the BCG vaccine

4. Why are three tubes needed for the QuantiFERON®-TB Gold Test?
a. The test is run in triplicate
b. There are different TB antigens or controls in each tube
c. The results of the three tubes are averaged to get the final result
d. None of the above are correct

5. Why must blood samples for QuantiFERON®-TB Gold Test be processed within 12 hours of collection?
a. The WBCs in the blood sample need to be viable in order to release the IFN-gamma when exposed to the TB antigens
b. The WBCs in the blood sample need time to be inactivated by the anticoagulant in the tube
c. The red blood cells with lyse after 12 hours
d. The IFN-gamma breaks down after 12 hours

6. QuantiFERON®-TB Gold Test can be used:
a. only when a patient has symptoms of tuberculosis and the skin test is negative
b. in all situations where a tuberculin skin test is now used
c. only to confirm a positive tuberculin skin test
d. only when a patient has a positive chest x-ray

7. Which of the following is TRUE?
a. A positive skin test means that you currently have active tuberculosis
b. A person with a positive skin test needs to be immunized for tuberculosis
c. A person who received the bacilli Calmette-Guerin (BCG) vaccine can have a positive skin test
d. The skin test can detect tuberculin immune response two to ten days after infection

8. An indeterminate or unreliable QuantiFERON®-TB Gold Test result can occur when:
a. the sample is not vigorously shaken immediately after collection
b. 18 hours passes between the time of collection and the time that the specimen is placed in a 37° incubator
c. Specimens are refrigerated during transport
d. All of the above

9. Tuberculosis spreads by:
a. Contact with contaminated surfaces
b. Through skin cuts and abrasions
c. Inhalation of airborne bacteria after a patient with tuberculosis coughs or sneezes
d. All of the above

10. The purpose of the Nil tube is:
a. To adjust for background
b. To adjust for presence of heterophile antibodies
c. To adjust for presence of non-specific IFN
d. All of the above are correct

11. The purpose of the Mitogen tube is:
a. It serves as a negative control for the test
b. It serves as a positive control for the test
c. It serves as a background interference check
d. It will have a high response value when there is reduced lymphocyte activity

12. The TB Antigen tube:
a. Contains M.tuberculosis antigens
b. Contains E. coli antigens to test for background interference
c. Contains proteins to detect mitogens
d. Contains antigens that test for cross-reacting antibodies

13. When collecting a blood specimen for the QuantiFERON®-TB Gold Test:
a. Each tube should be filled to the top
b. It is ok to only collect one or two of the three tubes if you have a difficult draw
c. If the tube does not completely fill, you must redraw the patient
d. Draw one ml. of blood into each tube

14. If the tubes fill slowly,
a. Don’t worry about it – this is expected
b. Redraw the patient because the blood will be hemolyzed
c. Draw extra tubes
d. Notify your supervisor

15. Immediately after blood sample collection:
a. Invert all three tubes gently for 1-3 seconds
b. Invert all three tubes gently for 5 seconds
c. Vigorously shake all three tubes for 1-3 seconds
d. Vigorously shake all three tubes for 5 seconds
e. These are clot tubes and do not require any kind of mixing

16. Filled tubes for QuantiFERON®-TB Gold Test should be transported:
a. At room temperature, unspun
b. On ice (refrigerated), unspun
c. Spun and frozen
d. Spun and protected from light

17. If you run out of QuantiFERON TB blood collection tubes:
a. you can use three sodium heparin vacutainer tube, mix by gentle inversion
b. you can use three lithium heparin vacutainer tube, mix by gentle inversion
c. a and b are both correct
d. you can ONLY use QuantiFERON TB blood collection tubes

18. When filling the QuantiFERON TB blood collection tubes:
a. fill only to the black mark on the side of the tube
b. completely fill the tube
c. it is acceptable to overfill or underfill the tube

19. Which of the following statements is true?
a. Used alone, the TST can differentiate latent infection from active disease
b. Used alone, the interferon-gamma release assays can differentiate latent infection from active disease
c. HIV Patients may have false-negative interferon-gamma release assays
d. All of the above are true

20. True or False - Vigorous shaking of the blood collection tubes does not harm the lymphocytes.
a. True
b. False

21. True or False - Frothing should be observed after shaking the filled blood collection tubes.
a. True
b. False

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